4.1 millions Americans underwent Botox injections in 2006. That's a pretty hefty number considering Botulinum Toxin Type A wasn't FDA approved for use in the treatment of wrinkles and frown lines until 2002. How long will Botox remain the #1 Minimally Invasive Cosmetic Procedure? I recently turned to several experts in the field of plastic surgery to find out which new products and procedures threaten to wipe Botox off the cosmeceutical map.

Available in France since the 1950's, MesoLift is a highly popular European wrinkle treatment consisting of micro-injections that contain multivitamins, hyaluronic acid and natural elements. Dr. Shirley Madhere, a New York plastic surgeon in private practice, coined the phrase "MesoGlow" because, "... the procedure imparts a healthy and radiant glow after its completion and only tightens skin with repeated treatments over time." Though MesoGlow is available in the United States, few practitioners administer the treatment at this time as it is a fairly new procedure in this country.

Dr. Madhere recommends starting off with three to five weekly sessions and then following up with one session every three to five months. This treatment may be for those with a little extra money to spend in the fight against aging skin as each session can cost from $500-$900. Dr. Madhere does treat some patients on a weekly basis, or for touchups during special circumstances, such as air flight, which can be dehydrating to the skin, and before a photo shoot, since MesoGlow creates a beautiful translucency to the skin that shows up well on camera.

In Dr. Madhere's book Aesthetic Mesotherapy and Injection Lipolysis in Clinical Practice she describes this treatment as having a triple effect by, "...increasing facial skin's tonicity and firmness over time, improving hydration, and imparting a radiant and healthy glow." Treatment is painless and the results last from six months to one year.

You may have heard of the downward dog, but what, you ask, is the Lion? Facial yoga seems to be catching on, particularly in New York, where yoga instructor Annelise Hagen teaches students ways in which to tone the facial muscles through yoga poses. Hagen has even written a book about this process titled The Yoga Face: Eliminate Wrinkles with the Ultimate Natural Facelift. Hagen maintains that our faces, much like our bodies, benefit from exercise. These toning exercises, coupled with the increased circulation from movement of the muscles, can help to reduce wrinkles.

According to its New Zealand website, Dysport-a "protein extracted from the bacterium Clostridium botulinum"-was developed in Britain in the 1990s for neurological and ophthalmic purposes, including cerebral palsy; after considerable research, it's now being used as a Botox alternative. Though not currently available in the United States, Dysport does have an FDA approval application pending.

Evolence 30 is one new product that's making a grand entrance in the filler world. Popular in over 17 countires, Evolence 30 has yet to be approved for use in the United States, but many physicians and researchers speculate that it will be within the next several years. Unlike the many bovine-based collagen fillers, which can cause severe allergic reactions in some, Evolence 30 is porcine (yes, as in pig) derived. Porcine-based collagen materials rarely cause allergic reactions because they are more compatible with the human body; in fact, porcine-based products have been used in heart valve replacements and surgical wound dressings for quite some time. Thanks to a new technology that slows biodegradability, the effects of Evolence 30 may last several years rather than just the few months that we currently see in other products, making Evolence 30 a potentially much longer term wrinkle reducer (sans surgery) than anything currently available on the market.

Approved by the FDA in July of 2007, Elevess is the first approved commercial hyaluronic acid filler that contains the local anesthetic lidocaine. As a result, patients might find that injections are less painful and that side effects at the injection site are fewer because the filler contains the lidocaine, eliminating additional injections. Side effects of Elevess may include those associated with other dermal fillers, including mild bruising, redness, and tenderness at the point of injection.

So you want something more permanent than a filler but less extensive than a full facelift? You're not alone! Manhattan-based plastic surgeon Dr. Jennifer Levine tells me that mini versions of facial plastic surgery are becoming quite popular, such as the mini-facelift. Explains Dr. Levin, the mini-face lift, "...incorporates small incisions and smaller areas of dissection to produce less swelling and faster healing."

Also known as a weekend lift due to its shorter surgery time and recovery period, the mini-facelift works to rid sagging and drooping on certain areas of the face, such as the neck and cheeks. Mini-lifts are often completed through the use of an endoscope, which means less cutting, less scarring and an easier recovery period than a full facelift. The endoscope, a wand-like device on which a camera is attached, is placed through one incision, allowing the surgeon to monitor the procedure on a screen. And considering a full face lift can put a $15,000 dent in your wallet while the average fee for a mini-lift runs about $5,000, the difference in price makes the mini-lift an even more attractive alternative.

If your skin is not too damaged or is just starting to show adverse signs of aging, this type of lift may work for you, especially when combined with other non-invasive measures to create the optimum effect. But if your skin has suffered extensive wrinkle damage. a full facelift may be the only option to reach the results you are hoping to attain.

Another alternative to the full-on facelift is the mid-lift, which focuses on the eyes and cheek area. Generally performed with the use of an endoscope, this option is perfect for those who who do not need the neck or chin area redone. . Since the full face is not involved, recovery time takes about one week and even less when an endoscope is used. A mid-lift will run you about $7,000.

First and foremost, says Dr. Shirley Madhere, keep in mind that " Beautiful skin is healthy skin that is maintained through eating right and exercising regularly." If you want to maintain your healthful, youthful appearance, take care of your body. Pop vitamins, stay hydrated, and like moms around the world have reiterated time and again, eat those veggies.

What's Next?

With technology growing and the relatively young field of plastic surgery taking flight, new medications and procedures are becoming available to help us fight those nasty little age reminders. Our mothers, slathering cold cream onto their faces each night, had no idea just what was lurking around the wrinkle-fighting corner, and who knows what might be discovered in the next twenty years? For now, though, natural remedies, yoga, new and improved fillers and less surgically invasive procedures seem a perfect addition to the fight against aging.

And as Dr. Madhere so eloquently states, "In the race against the ill effects of the clock, Father Time may have to yield, even if only temporarily, for Mother Beauty."